Evidence-based interventions to promote physical activity: what contributes to dissemination by state health departments.

BACKGROUND: Evidence-based guidelines for promoting physical activity have been produced, yet sparse information exists on the dissemination of effective interventions. The purpose of this study was to better understand the dissemination of physical activity interventions across the United States, focusing particularly on evidence-based guidelines. DESIGN: A cross-sectional study was conducted in the U.S. that was organized around a modified version of the diffusion of innovations theory. SETTING/PARTICIPANTS: Respondents (n=49) were the physical activity contact person (e.g., program administrator, health educator) in each state or territorial health department. MAIN OUTCOME MEASURES: Seven specific programs and policies relating to physical activity intervention were examined as dependent variables. Five additional domains--organizational climate, awareness, adoption, implementation, and maintenance--framed a set of independent variables. RESULTS: The most important factor related to decision making was the availability of adequate resources. Most respondents (89.8%) were aware of evidence-based guidelines to promote physical activity. However, less than half of the respondents (41%) had the authority to implement evidence-based programs and policies. A minority of respondents reported having support from their state governor (35.4%) or from most of their state legislators (21.3%). Several key factors were associated with the adoption of evidence-based interventions, including the presence of state funding for physical activity, whether the respondent participated in moderate physical activity, presence of adequate staffing, and presence of a supportive state legislature. CONCLUSIONS: Awareness of the importance of promoting physical activity is relatively high in state and territorial health departments; however, the levels of internal support within the health department appear to outweigh any outside support from elected officials.

Translating research into improved outcomes in comprehensive cancer control.

A key question in moving comprehensive cancer control (CCC) plans into action is, to what extent should the knowledge gained from investments in cancer prevention and control research influence the actions taken by states, tribes, and territories during implementation? Underlying this 'should' is the assumption that evidence-based approaches (i.e., a public health or clinical intervention or policy that has resulted in improved outcomes when scientifically tested), when implemented in a real-world setting, will increase the likelihood of improved outcomes. This article elucidates the barriers and opportunities for integrating science with practice across the cancer control continuum. However, given the scope of CCC and the substantial investment in generating new knowledge through science, it is difficult for any one agency, on its own, to make a sufficient investment to ensure new knowledge is translated and implemented at a national, state, or local level. Thus, if greater demand for evidence-based interventions and increased resources for adopting them are going to support the dissemination initiatives described herein, new interagency partnerships must be developed to ensure that sufficient means are dedicated to integrating science with service. Furthermore, for these collaborations to increase both in size and in frequency, agency leaders must clearly articulate their support for these collaborative initiatives and explicitly recognize those collaborative efforts that are successful. In this way, the whole (in this context, comprehensive cancer control) can become greater than the sum of its parts.

Getting people to want sliced bread--an update on dissemination of the Guide to Community Preventive Services.

This article provides an overview and update on dissemination strategies regarding the Guide to Community Preventive Services (Community Guide), a federally sponsored and independently led initiative to develop evidence-based findings on the effectiveness of selected population-based interventions. Despite the innovative nature, barriers to dissemination and utilization of Community Guide findings exist. Terms and concepts used to guide dissemination efforts designed to address these barriers are identified and discussed.